TLDR: Ketone levels above 2mmol/l show significant improvements in patients with Euthymic bipolar disorder.
Of 27 recruited participants, 26 began and 20 completed the ketogenic diet. For participants completing the intervention, mean body weight fell by 4.2 kg (P < 0.001), mean body mass index fell by 1.5 kg/m2 (P < 0.001) and mean systolic blood pressure fell by 7.4 mmHg (P < 0.041). The euthymic participants had average baseline and follow-up assessments consistent with them being in the euthymic range with no statistically significant changes in Affective Lability Scale-18, Beck Depression Inventory and Young Mania Rating Scale. In participants providing reliable daily ecological momentary assessment data (n = 14), there was a positive correlation between daily ketone levels and self-rated mood (r = 0.21, P < 0.001) and energy (r = 0.19 P < 0.001), and an inverse correlation between ketone levels and both impulsivity (r = −0.30, P < 0.001) and anxiety (r = −0.19, P < 0.001). From the MRS measurements, brain glutamate plus glutamine concentration decreased by 11.6% in the anterior cingulate cortex (P = 0.025) and fell by 13.6% in the posterior cingulate cortex (P = <0.001).
These findings suggest that a ketogenic diet may be clinically useful in bipolar disorder, for both mental health and metabolic outcomes. Replication and randomised controlled trials are now warranted.
Full Paper: https://doi.org/10.1192/bjo.2024.841
It is interesting as a mere side effect of going keto the patients lost 4.2kg, drops 7 systolic blood pressure points… Its a really well controlled demonstration of how powerful a ketogenic metabolism is, and how quickly people can see positive improvements.
Bipolar disorder carries a substantial metabolic burden, with high rates of obesity, type 2 diabetes, cardiovascular disease and reduced life expectancy.
In consideration of blood cholesterol and triglycerides, a preference for unsaturated fats was advised.
Big ooph, but its fair enough, they dont want to rock more then one boat at a time for novel research.
Seven of the 20 participants who completed the intervention requested not to participate in the dietary cessation period and opted to continue on a ketogenic diet.
The lead author, Dr. Campbell has done a interview about this study and future research: https://www.youtube.com/watch?v=v3zEbwfbVP0
Limitations:
- Pilot study
- Euthymic patients
- Funding from Roblox
- Small cohort, but CLINICALLY significant results
- Period of observation 6 weeks vs the more standard 3 months.
- single group, non-randomised, open interventional, no control group